Provider Demographics
NPI:1487439451
Name:KUANG, LONGXIANG
Entity type:Individual
Prefix:
First Name:LONGXIANG
Middle Name:
Last Name:KUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-2036
Mailing Address - Country:US
Mailing Address - Phone:830-876-3506
Mailing Address - Fax:
Practice Address - Street 1:2214 N 1ST ST
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-2036
Practice Address - Country:US
Practice Address - Phone:830-876-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist